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Physiology > Exam II | CNS > Flashcards

Exam II | CNS Flashcards

1
Q

What are spinal enlargements?

A

widening of the cord in cervical and lumbar regions due to additional wiring to the upper and lower limbs, respectively

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2
Q

How does the ratio of white to gray matter change down the length of the cord?

A

the ratio decreases (there is less white matter compared to gray matter), with the exception of the thoracic region

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3
Q

What cells line the central canal, and how does it change over time?

A
  • ependymal cells

- becomes occluded with age

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4
Q

What is the conus medullaris, and where does it end?

A
  • the end of the spinal cord

- ends between L1 and L2

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5
Q

What are 2 structural modifications of the pia mater?

A
  • filum terminale

- denticulate ligament

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6
Q

What is the filum terminale, and what is its significance?

A
  • a filamentous extension of the pia mater from the medullary cone to the coccyx
  • it has no neural function
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7
Q

What is the function of the denticulate ligament?

A

-helps to hold white matter of cord in place relative to the dura mater

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8
Q

What is the cauda equina composed of?

A
  • a bundle of spinal nerves and spinal nerve rootlets

- contains nerve pairs L2-L5, S1-S5, and the coccygeal nerve

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9
Q

How do the roots of the cord change along the cord length?

A

the roots lengthen, to accommodate the cauda equina

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10
Q

How can you tell the difference between dorsal and ventral horns?

A

dorsal horns extend to the edge

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11
Q

What is the level of termination of the cervical cord?

A

C7

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12
Q

What is the level of termination of the thoracic cord?

A

stops before T12

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13
Q

What is the level of termination of the lumbar cord?

A

stops before L1

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14
Q

Where is the sacral region of the cord?

A

L1

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15
Q

What is the epidural space?

A

The space between dura mater and vertebral wall. It is superficial to dura mater

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16
Q

At what level is an epidural or LP done? What is the difference between the two?

A
  • always below the cord (below L1)
  • LP penetrates dura mater to extract CSF from subarachnoid space. Sometimes done in sacral region
  • epidural injects anesthetic superficial to dura mater, in epidural space
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17
Q

How long is the typical spinal cord?

A

less than 20” long

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18
Q

Where is the superior sagittal sinus, and what does it contain?

A
  • a dural compartment between dura and arachnoid mater

- contains low pressure venous blood

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19
Q

Where is the subarachnoid located, and what fluid does it contain?

A
  • Between the pia mater and the arachnoid mater

- contains CSF

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20
Q

Arachnoid villi structure, function, and location

A
  • herniations of the arachnoid membrane that penetrate the overlying dura and invaginate through the walls of the cranial dural sinuses
  • return CSF to venous blood of cranial sinus, esp. superior sagittal sinus
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21
Q

what is the choroid plexus?

A
  • a tissue in the ventricles of the brain that produces CSF from blood
  • creates a positive pressure to facilitate flow back into subarachnoid space
  • also clears out amyloid and other misfolded proteins
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22
Q

CSF circulation

A
  • leaves cranial sinus of choroid plexus
  • circulates downward form lateral ventricles into 3rd and 4th ventricles
  • then around (subarachnoid space) and through (central canal) the spinal cord
  • and around entire brain
  • pressure drives CSF in arachnoid space through arachnoid villi and back into the venous blood of cranial sinuses
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23
Q

What makes up the white columns of the spinal cord?

A

posterior, lateral, and anterior funiculus

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24
Q

what branches off the spinal nerve?

A
  • dorsal ramus
  • ventral ramus
  • grey and white rami communicantes
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25
Q

What connects spinal nerve to sympathetic chain?

A

gray and white rami communicantes

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26
Q

What nerves does the dorsal ramus have? The ventral ramus? Explain.

A
  • both have mixed nerves
  • dorsal ramus has longer branches (tend to be sensory, reach cutaneous layer) and shorter branches (are motor, reach erector spinae muscles)
  • ventral ramus also has cutaneous branches which are sensory
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27
Q

Which rami form nerve plexuses?

A

ventral rami of C1-T1 and L1-S4

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28
Q

incomplete SCI

A

at least partial sensory OR motor function is retained below the site of injury

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29
Q

complete SCI

A

total loss of sensory AND motor function below site of injury (both sides effected equally)

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30
Q

What are the complications of SCI?

A
  • bowel/ bladder dysfunction
  • respiratory and heart problems
  • chronic pain
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31
Q

What fraction of SCI patients require ventilatory assistance?

A

1/3

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32
Q

Paraplegia

A
  • results from injuries lower on the spine

- affects parts of trunk, pelvic region, and legs

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33
Q

Quadriplegia

A
  • results from injuries higher on the spine

- affects trunk, arms, legs, hands, and pelvic region

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34
Q

hemiplegia

A

complete loss of sensorimotor function one one side of the body

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35
Q

What are common therapies for SCI?

A
  • steroid therapy helpful if administered early
  • rehab
  • physical therapy
  • electrical stimulation
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36
Q

What determines amount of sensorimotor loss of SCI?

A
  • level of injury

- laterality of injury

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37
Q

What are the characteristics of the dura mater?

A
  • tough
  • fibrous
  • densely infused with nociceptors
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38
Q

What are the 2 layers of the dura mater?

A
  • periosteal
  • meningeal
  • sperate at the superior sagittal sinus
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39
Q

What is the tentorium cerebelli?

A

a portion of the dura mater that separates the cerebrum from the cerebellum

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40
Q

What is the falx cerebri?

A
  • a portion of the dura mater that separates the two cerebral hemispheres
  • made up of dural meningeal layer
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41
Q

What are the characteristics of the arachnoid mater?

A
  • thin
  • extensively vascularized
  • with arachnoid processes extending toward pia
  • subarachnoid space filled with CSF
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42
Q

What are the characteristics of the pia mater?

A
  • very thin, delicate

- tightly bound to surface of brain and blood vessels

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43
Q

What causes meningitis?

A

viral, bacterial, or fungal infection of CNS or meninges

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44
Q

What form of meningitis is most severe?

A

bacterial

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45
Q

What bacteria cause meningitis?

A

haemophilis, pneumococcus, and meningococcus

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46
Q

What are the symptoms of meningitis?

A
  • HA
  • high fever
  • altered mental status
  • phonophobia and photophobia
  • nuchal rigidity
  • petechiae in trunk, membranes, and extremities (if meningococcal)
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47
Q

blood composition changes in response to what?

A
  • diet
  • exercise
  • stress
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48
Q

BBB function

A
  • ensures brain receives correct mixture of nutrients (since CNS is not able to handle large variations in blood composition)
  • allows passage of water, some molecules, and small proteins
  • removes potential toxins
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49
Q

What is levadopa?

A
  • a dopamine precursor used in the management of Parkinson’s disease
  • dopamine cannot cross BBB
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50
Q

What acts as an intermediary between blood and neurons in the BBB?

A
  • specialized capillaries with endothelial cells made up tight and gap junctions
  • membrane transporters
  • astrocytes
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51
Q

What type of transport allows for transfer of nutrients and wastes in BBB?

A
  • simple diffusion
  • facilitated diffusion
  • active transport
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52
Q

What characteristics do drugs need to have to be able to pass BBB?

A
  • a high partition coefficient (lipophilicity and size smaller than 500 Da)
  • evasion of active extrusion (from video)
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53
Q

What would happen if arachnoid villi were not functioning properly?

A

hydrocephalus

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54
Q

What connects third and 4th ventricle?

A

cerebral aqueduct of midbrain

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55
Q

what joins the lateral ventricles?

A

intraventricular foramen

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56
Q

What does the 4th ventricle give rise to inferiorly?

A

the central canal

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57
Q

How much CSF do the ventricles contain?

A

40 mL

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58
Q

How much CSF does the entire CNS contain?

A

150 mL

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59
Q

How much CSF is produced in the body each day?

A

500 mL

60
Q

How does CSF composition compare to that of blood?

A
  • more acidic
  • lower concentration of K+ and Ca2+
  • no RBCs, smaller number of WBCs
  • smaller amount of proteins, lipids, hormones, microRNAs, cholesterol, & metabolites
61
Q

What is the difference between diploic and emissary veins?

A
  • diploic veins extend through middle portion of cranial bone into interior
  • emissary bones extend from skull surface to interior
62
Q

What can cause nasal CSF drainage?

A

pathology, trauma, or genetic disorder of the sphenoid bone

63
Q

How much CSF is turned over each day?

A

0.5L (same as amount produced each day)

64
Q

What are the functions of CSF?

A
  • provides appropriate environment for neurons and nutrients

- provides buoyant medium for brain, providing hydraulic protection against physical trauma

65
Q

Choroid cell function

A
  • monitor CSF compositions

- regulate admission of immune cells, ions, and some proteins in the brain

66
Q

Choroid plexus atrophy is seen in what ailments?

A
  • Alzheimer’s dz
  • CVA
  • MS
  • psychiatric diseases
67
Q

Choroid plexus atrophy leads to what?

A

reduced clearance of amyloids and misfolded proteins

68
Q

primary cilium is found in what kind of cells?

A
  • metabolically active cells
  • most epithelial cells
  • most neurons
  • choroid cells
  • ependymocytes
69
Q

Glymphatic system function

A

contribute to nightly clearance of metabolic wastes from the brain during sleep

70
Q

What does the glymphatic system require to function?

A

an efficient choroid and astrocytes to regulate flow of blood and CSF through the ECF

71
Q

What connects the flow of CSF from the pararterial areas to the paravenous areas in the glymphatic system?

A

the brain parenchyma

72
Q

What may happen to neurons while you sleep?

A

they may shrink up to 40% in order to facilitate flow of cleansing fluids and removal of waste products

73
Q

What percent of wastes may be removed by the glymphatic system?

A

up to 80% of protein waste and other metabolites

74
Q

Where is the brainstem located?

A

between cerebrum and spinal cord

75
Q

Where is the pineal gland located?

A

behind the brainstem

76
Q

What is a brainstem patient?

A

patient is breathing and with heartbeat but cerebrum no longer functionally attached to brainstem

77
Q

How can you tell what view of the brainstem you are looking at?

A

the anterior of the pons is protruding

78
Q

What is decussation?

A
  • the point at which the fibers cross the midline

- this is what allows your left brain to control your right limbs and vice versa

79
Q

Where does motor decussation occur?

A

at the anterior medulla, at the pyramidal tracts

80
Q

what is the medial lemniscus made of?

A

cuneate and gracile fasciculus

81
Q

Where does sensory decussation occur?

A

at the medial lemniscus of posterior medulla

82
Q

What cranial nerves are on the medulla?

A

X, XI, & XII

83
Q

What are the medullary vital centers?

A
  • cardiac center: regulates HR and stoke volume
  • vasomotor center: regulates vasomotor tone
  • respiratory center: with pons, regulates rhythm, rate, & depth of breathing
84
Q

What do the medullary nuclei do? Name them.

A

work in concert with ANS to regulate BP, HR, and RR.

  • nucleus cuneatus
  • nucleus gracilis
  • olivary nucleus
85
Q

______ arteries converge at the medulla.

A

vertebral

86
Q

What is the largest part of the brainstem?

A

the pons

87
Q

What is the adjective for pons?

A

pontine

88
Q

What cranial nerves extend from pons nuclei?

A

V, VI, VII & VIII

89
Q

What is anterior to the pons?

A

4th ventricle

90
Q

What are the respiratory centers, and where are they located?

A

located in the pons

  • pneumotaxic center
  • apnesustic center
91
Q

superior colliculi are located where and responsible for what?

A
  • located in midbrain

- responsible for reflex movements of eyes, head, and neck for visual stimuli

92
Q

What are the cerebral peduncles?

A
  • descending pyramidal tracts to cerebellum from the midbrain
  • made of white matter
93
Q

what is the substantia nigra?

A
  • dopaminergic part of basal nuclei
  • dark due to neuromelanin
  • plays critical role in movement, reward, & addiction
94
Q

What causes Parkinson’s disease?

A

loss of dopamine in SNpc (nigrostriatal pathway)

95
Q

Describe the red nuclei of the midbrain.

A
  • has blood vessels

- is a motor tract. regulates posture & muscle tone

96
Q

inferior colliculi are located where and responsible for what?

A
  • located in the midbrain

- responsible for reflex movements of head, neck, and trunk from auditory stimuli

97
Q

What cranial nerve nucleus does the midbrain have?

A

oculomotor nucleus

98
Q

What is reticular formation, and where is it located?

A
  • scattered throughout brainstem
  • involved in vigilance, consciousness, arousal
  • serotonergic elements affect mood, habituation
99
Q

What is habituation?

A

occurs when animals are exposed to the same stimuli repeatedly, and eventually stop responding to that stimulus

100
Q

Location of hypothalamus

A
  • anterior and somewhat inferior to thalamus
  • superior to pituitary
  • anterior to midbrain
101
Q

What is the diencephalon made up of?

A

mostly of thalamus. there’s also hypothalamus, epithalamus, and subthalamus

102
Q

what are the 4 types of hypothalamic nuclei?

A
  • mamillary region
  • tuberal region
  • supraoptic region
  • preoptic region
103
Q

What does the hypothalamus regulate?

A
  • endocrine and ANS
  • hunger, satiety, thirst
  • body temperature
  • aspects of sleep and fatigue
  • behaviors (e.g. parenting, bonding)
  • part of the limbic system (basic drives, emotions, bodily responses to emotion)
104
Q

thalamus location

A
  • just above brainstem

- adjacent to third ventricle

105
Q

What is thalamocortical chatter?

A

interactions between thalamus and mostly sensory regions of cerebral cortex

106
Q

All sensory information (except olfactory, are conveyed directly to what nuclei?

A

thalamic nuclei

  • medial geniculate
  • lateral geniculate
  • ventral posterior
  • ventral anterior
107
Q

What is the difference between lateral geniculate and medial geniculate nuclei?

A
  • lateral receives retinal signals

- medial receives auditory inputs

108
Q

The thalamus has extensive interconnections with what two structures?

A
  • cerebral cortex (mostly sensory regions)

- basal nuclei

109
Q

How does the thalamus process complex sensory info?

A

filters, prioritizes, evaluates, then sends signals to other regions of the brain for further analysis

110
Q

What sensations are conveyed to thalamus via the spinothalamic tract?

A
  • pain
  • temperature
  • crude touch
111
Q

Importance of thalamus

A
  • initial integration/processing of sensory info
  • contributes to vigilance and alertness
  • hippocampal circuits suggest role in memory
112
Q

What 2 brain structures play a role in vigilance?

A
  • thalamus

- reticular formation of midbrain

113
Q

Where is the ventral posterior nuclei located, and where does the relay information?

A
  • thalamus

- to somatosensory cortex

114
Q

Where is the ventral anterior nuclei located, and where does the relay information?

A
  • thalamus

- to prefrontal cortex

115
Q

Cerebellum location

A

posterior to pons and 4th ventricle

116
Q

How does the cerebellum compare to the cerebrum in cellular composition?

A

has 3 more cells than cerebellum

117
Q

cerebellum function

A
  • allows for precisely timed and coordinated movements, and motor learning
  • uses sensory info to rapidly correct motor signals
118
Q

What is a peduncle, and what are the 3 cerebellar peduncles?

A

-a white matter pathway

superior, middle, and inferior cerebellar peduncles

119
Q

What is meant by calling the cerebellum an analytical comparator?

A

it uses sensory info to rapidly correct motor signals, ensuring that actual movements correspond to intentions

120
Q

What side to cerebellar efferents control?

A

the same side; they’re ipsilateral

121
Q

cerebellar patients often have what characteristics?

A
  • moving slowly or awkwardly

- falling

122
Q

What is asynergia?

A

impaired coordination

123
Q

What is dysmetria?

A

inability to estimate distances

124
Q

unfolding the cerebellum would produce a sheet how long?

A

1 meter

125
Q

What is adiadochokinesia?

A

inability to make rapid, repetitive movements

126
Q

What is an intention tremor?

A

involuntary, rhythmic muscle contractions (oscillations) that occur during a purposeful, voluntary movement

127
Q

Cerebellar ataxia is characterized as what?

A

wide foot movements when walking

128
Q

What is hypotonia?

A

weak, flaccid muscles

129
Q

What are the cells of the cerebellum?

A
  • Purkinje cells
  • Golgi cells
  • Basket Cell
  • Granule cell
  • stellate cells
  • Mossy fibers
  • climbing fibers
130
Q

cerebellum structure

A
  • molecular layer (superficial)
  • granular layer (deep)
  • Purkinje cells between these two layers send large axons to the inner white matter and deep cerebellar nuclei
  • White matter branching termed arbor vitae
131
Q

Purkinje cells

A
  • dendrites extend into molecular layer of cerebellum
  • axons extend to the inner white matter and deep cerebellar nuclei
  • are GABAergic
132
Q

What are basal nuclei?

A
  • Regions of gray matter located within myelinated white matter covering the brain
  • extend from midbrain to adjacent of lateral ventricles
  • essential for normal, voluntary movement
133
Q

What are the components of the basal nuclei?

A
  • lentiform nucleus (putamen and globus pallidus)
  • caudate
  • previous two make up the striatum
  • nucleus accumbens
  • SNpc
134
Q

What is the striatum, and what basal nuclei components does it contain?

A
  • superior portion of nigrostriatal pathway
  • dopaminergic and glutamatergic
  • has lentiform nucleus globus pallidus and caudate)
135
Q

What 3 regions of the brain are responsible for motor function?

A
  • cerebellum
  • motor cortex
  • basal nuclei
136
Q

Damage to the striatum is responsible for what disease?

A

Huntington’s

137
Q

Insult to basal nuclei can lead to what ailments?

A
  • Huntington’s dz
  • Parkinson’s dz
  • OCD
  • Tourette’s
  • hemiballismus
138
Q

What is meant by calling the basal nuclei a filtration system?

A

“selects” correct motor sequence for the desired outcome and acts to inhibit or constrain gross movements

139
Q

basal nuclei function

A
  • essential for normal, voluntary movement
  • learning of motor “routines” (e.g. tying shoe, playing instrument, driving car)
  • possibly emotions and other aspects of learning
140
Q

What are the symptoms of Parkinson’s disease?

A
  • impaired voluntary movement
  • tremors
  • exaggerated movement
  • freezing
141
Q

What is the general confirmation of the hippocampus?

A

C-shaped structure in medial temporal lobe, posterior to amygdala

142
Q

Damage to the hippocampus leads to what?

A

memory impairment

143
Q

What tends to decrease hippocampal size?

A

depression

144
Q

Hippocampus function

A
  • essential for memory formation
  • esp. important for learning of location and time relationships (e.g. navigation)
  • place cells and grid cells enable animals to construct mental maps of their surroundings
  • part of the limbic system which plays a role in emotions
145
Q

How does something become long term memory?

A
  • after immediate sensory data is temporarily transcribed by neurons in the cortex, it gets sent to the hippocampus where special proteins work to strengthen cortical synaptic connections
  • if the experience was strong enough or we remember it periodically for the first few days, the hippocampus transfers the memory back to the cortex for permanent storage
146
Q

What is the difference between memory formation in the basal ganglia and cerebellum and memory formation in the hippocampus?

A
  • hippocampus has declarative memory (name, dates, and facts)
  • cerebellum and basal nuclei control procedural memory (signing your name, riding a bike)

Physiology (10 decks)

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